Clinical Efficacy of the Spot Vision Screener for Measuring Refraction and Detecting Strabismus in Children

Purpose: To investigate the clinical efficacy of the Spot Vision Screener in measuring refractive power and detecting strabismus in pediatric patients. Methods: We retrospectively analyzed the spherical equivalent, cylinder, and strabismus using the Spot Vision Screener before cycloplegic refraction for pediatric patients <10 years of age. We compared the spherical equivalent and cylinder using the Spot Vision Screener with the results of cycloplegic refraction, and we measured the accuracy of the Spot Vision Screener in detecting strabismus compared with the alternate prism cover test. Results: A total of 38 eyes of 19 patients were included in this study. There was no significant difference in spherical equivalent between the Spot Vision Screener before cycloplegic refraction and cycloplegic refraction (paired t-test: -0.25 +/- 1.12 diopters [D] vs. 0.04 +/- 1.86 D; p = 0.12). There was a significant difference in cylinder between the Spot Vision Screener before cycloplegic refraction and cycloplegic refraction, but the difference was only -0.25 D (paired t-test: -1.41 +/- 1.16 D vs. -1.16 +/- 1.25 D; p = 0.01). The sensitivity of the Spot Vision Screener was 42.86%, and the specificity was 66.67% for detecting strabismus. Conclusions: The Spot Vision Screener was a useful instrument to measure the refractive power in pediatric patients before cycloplegic refraction, but it had poor sensitivity and specificity for detecting strabismus.